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"Damage control surgery"

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https://www.readbyqxmd.com/read/28933334/-damage-control-surgery-in-polytrauma-patients-with-pelvic-fractures-is-it-possible-to-use-internal-fixation
#1
L Havlůj, V Džupa, R Gürlich
Current polytrauma management is multidisciplinary, with Damage Control Surgery (DCS), Damage Control Orthopaedics (DCO) and Damage Control Resuscitation (DCR) being applied in the first few hours after injury. The most severe group of polytrauma patients are those with circulatory instability and massive blood loss as a consequence of unstable pelvic fractures. In treating these patients, of crucial importance is the speed and quality of stabilisation of pelvic fracture fragments. The authors present two case reports of polytrauma patients with unstable pelvic fractures, in whom open reduction and internal fixation was performed on the anterior fracture segment through extended laparotomy in order to stop bleeding into the abdominopelvic cavity as part of the DCS approach...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28932257/a-novel-method-for-multiple-bowel-injuries-a-pilot-canine-experiment
#2
Jun Ke, Weihang Wu, Nan Lin, Weijin Yang, Zhicong Cai, Wei Wu, Dongsheng Chen, Yu Wang
BACKGROUND: Intestinal ligation is the cornerstone for damage control in abdominal emergency, yet it may lead to bowel ischemia. Although intestinal ligation avoids further peritoneal cavity pollution, it may lead to an increased pressure within the bowel segments and rapid bacterial translocation. In this study, we showed that severed intestine could be readily reconnected by using silicon tubes and be secured by using rubber bands in a canine model. METHODS: Adult Beagle dogs, subject to multiple intestinal transections and hemorrhagic shock by exsanguination, randomly received conventional ligation vs...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28910466/surgical-instrument-sets-for-special-operations-expeditionary-surgical-teams
#3
Diane F Hale, Justin C Sexton, Linda C Benavides, Jerry M Benavides, Jonathan B Lundy
BACKGROUND: The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. METHODS: The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28893227/damage-control-surgery-experiences-from-a-level-i-trauma-center
#4
Bernhard Gasser, Thomas M Tiefenboeck, Sandra Boesmueller, Danijel Kivaranovic, Adam Bukaty, Patrick Platzer
BACKGROUND: There is still no evidence in literature for damage control orthopaedics (DCO), early total care (ETC) or using external fixation solely in fractures of the long bones in multi-system-trauma. The aim of this study was to determine parameters influencing the choice of treatment in clinical routine (DCO, ETC, or EF) in femoral or tibial shaft fractures in combination with multi-system-trauma, severe soft tissue damage or both. METHODS: Data of 236 patients with 280 fractures of long bones of the lower extremities treated at a level I trauma center were analysed...
September 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28882359/integrating-technical-and-non-technical-skills-coaching-in-an-acute-trauma-surgery-team-training-is-it-too-much
#5
Alexander Alken, Jan-Maarten Luursema, Mariska Weenk, Simon Yauw, Cornelia Fluit, Harry van Goor
OBJECTIVE: Research on effective integration of technical and non-technical skills in surgery team training is sparse. In a previous study we found that surgical teachers predominantly coached on technical and hardly on non-technical skills during the Definitive Surgical and Anesthetic Trauma Care (DSATC) integrated acute trauma surgery team training. This study aims to investigate whether the priming of teachers could increase the amount of non-technical skills coaching during such a training...
August 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28877534/open-abdomen-improves-survival-in-patients-with-peritonitis-secondary-to-acute-superior-mesenteric-artery-occlusion
#6
Weiwei Ding, Kai Wang, Baochen Liu, Xinxin Fan, Shikai Wang, Jianmin Cao, Xingjiang Wu, Jieshou Li
BACKGROUND: Damage control surgery and open abdomen (OA) have been extensively used in the severe traumatic patients. However, there was little information when extended to a nontrauma setting. The purpose of this study was to evaluate whether the liberal use of OA as a damage control surgery adjunct improved the clinical outcome in acute superior mesenteric artery occlusion patients. STUDY DESIGN: A single-center, retrospective cohort review was performed in a national tertiary surgical referral center...
October 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28871350/-approach-to-liver-spleen-and-pancreatic-injuries-including-damage-control-surgery-of-terrorist-attacks
#7
REVIEW
G A Stavrou, M J Lipp, K J Oldhafer
BACKGROUND: Terrorist attacks have outreached to Europe with more and more attacks on civilians. Derived from war surgery experience and from lessons learned from major incidents, it seems mandatory for every surgeon to improve understanding of the special circumstances of trauma following a terrorist attack and its' management. METHOD: A short literature review is followed by outlining the damage control surgery (DCS) principle for each organ system with practical comments from the perspective of a specialized hepatobiliary (HPB) surgery unit...
September 4, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28838022/-characteristics-and-treatment-strategies-for-penetrating-injuries-on-the-example-of-gunshot-and-blast-victims-without-ballistic-body-armour-in-afghanistan-2009%C3%A2-%C3%A2-2013
#8
Christoph Güsgen, Arnulf Willms, Ines Richardsen, Dan Bieler, Erwin Kollig, Robert Schwab
Much like other countries, Germany has recently seen terrorist attacks being planned, executed or prevented at the last minute. This highlights the need for expertise in the treatment of penetrating torso traumas by bullets or explosions. Data on the treatment of firearm injuries and, even more so, blast injuries often stems from crises or war regions. However, it is difficult to compare injuries from such regions with injuries from civilian terrorist attacks due to the ballistic body protection (protective vests, body armour) worn by soldiers...
August 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28831516/-management-of-traumatic-intestinal-injury-of-mass-casualties
#9
REVIEW
J F Lock, F Anger, C-T Germer
While intestinal injury is relatively rare in blunt abdominal trauma, it is common in penetrating abdominal trauma. Intestinal injury cannot be detected effectively by computed tomography (CT); therefore penetrating abdominal injury or abdominal signs in blunt trauma require liberal indications for explorative laparotomy. In mass casualty situations patients with hemodynamic instability and abdominal signs should be prioritized for surgery. Besides intra-abdominal hemorrhage the major issue is septic complications due to intestinal perforation...
August 22, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#10
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28801785/-treatment-strategies-for-mass-casualty-incidents-and-terrorist-attacks-in-trauma-and-vascular-surgery-presentation-of-a-treatment-concept
#11
REVIEW
B Friemert, A Franke, D Bieler, A Achatz, D Hinck, M Engelhardt
The treatment of patients in the context of mass casualty incidents (MCI) represents a great challenge for the participating rescue workers and clinics. Due to the increase in terrorist activities it is necessary to become familiar with this new kind of threat to civilization with respect to the medical treatment of victims of terrorist attacks. There are substantial differences between a "normal" MCI and a terrorist MCI with respect to injury patterns (blunt trauma vs. penetrating/perforating trauma), the type and form of the incident (MCI=static situation vs...
August 11, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28762453/damage-control-surgery-6-years-of-experience-at-a-level-i-trauma-center
#12
Amit Gupta, Subodh Kumar, Sushma Sagar, Pawan Sharma, Biplab Mishra, Maneesh Singhal, Mahesh C Misra
BACKGROUND: Damage control surgery (DCS) has been a well-established practice in the management of trauma victims for more than 2 decades now. The primary aim of this study was to review and analyze the presentation and outcome of patients with torso trauma who underwent DCS at Level I trauma center. METHODS: Retrospective study was conducted using database records prospectively maintained over period of 6 years from 2008 through 2013 at an urban Level I trauma center...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28737565/use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-a-multidisciplinary-approach
#13
Carolina Nilsson, Linda Bilos, Tal Hörer, Artai Pirouzram
The usage of resuscitative endovascular balloon occlusion of the aorta, also known as aortic balloon occlusion, is an emerging method for bleeding control as a bridge to definitive treatment in trauma management. We describe a trauma case where resuscitative endovascular balloon occlusion of the aorta was used as part of the EndoVascular hybrid Trauma and bleeding Management concept to facilitate transient hemorrhage control and thereby to permit damage control surgery. The case is an illustration of the adoption of a multidisciplinary approach...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28704250/abnormal-calcium-levels-during-trauma-resuscitation-are-associated-with-increased-mortality-increased-blood-product-use-and-greater-hospital-resource-consumption-a-pilot-investigation
#14
Emily J MacKay, Michael D Stubna, Daniel N Holena, Patrick M Reilly, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Jeremy W Cannon
BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in the first 24 hours after severe injury is associated with increased mortality. METHODS: All patients at our institution with massive transfusion protocol activation from January 2013 through December 2014 were identified...
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28628601/the-damage-control-surgery-in-austere-environments-research-group-dcsaerg-a-dynamic-program-to-facilitate-real-time-telementoring-telediagnosis-to-address-exsanguination-in-extreme-and-austere-environments
#15
Andrew W Kirkpatrick, Jessica L McKee, Paul B McBeth, Chad G Ball, Anthony LaPorta, Timothy Broderick, Tim Leslie, David King, Heather E Wright Beatty, Jocelyn Keillor, Homer Tien
Hemorrhage is the most preventable cause of posttraumatic death. Many cases are potentially anatomically salvageable, yet remain lethal without logistics or trained personnel to deliver diagnosis or resuscitative surgery in austere environments. Revolutions in technology for remote mentoring of ultrasound and surgery may enhance capabilities to utilize the skill sets of non-physicians. Thus, our research collaborative explored remote mentoring to empower non-physicians to address junctional and torso hemorrhage control in austere environments...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28612105/-polytrauma-and-concomitant-traumatic-brain-injury-the-role-of-the-trauma-surgeon
#16
REVIEW
A Antoni, T Heinz, J Leitgeb
BACKGROUND: Concomitant traumatic brain injury (TBI) increases mortality and reduces quality of life of polytrauma patients. These facts demand effective treatment strategies while the growing specialization of medicine is questioning the role of the trauma surgeon in the management of these patients. OBJECTIVES: Which factors influence outcome of polytrauma with concomitant TBI? Who should be responsible for the management of these patients and what is the limit of management? MATERIALS AND METHODS: A literature search using Medline via PubMed was performed with Medical Subject Headings and text word search...
June 13, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28590354/optimal-timing-for-repair-of-peripheral-nerve-injuries
#17
Eugene Wang, Kenji Inaba, Saskya Byerly, Diandra Escamilla, Jayun Cho, Joseph Carey, Milan Stevanovic, Alidad Ghiassi, Demetrios Demetriades
BACKGROUND: Data regarding outcomes after peripheral nerve injuries is limited, and the optimal management strategy for an acute injury is unclear. The aim of this study was to examine timing of repair and specific factors that impact motor-sensory outcomes after peripheral nerve injury. METHODS: This was a single center, retrospective study. Patients with traumatic peripheral nerve injury 01/2010 - 06/2015 were included. Patients who died, required amputation, suffered brachial plexus injury, or had missing motor-sensory exams were excluded...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28542848/change-of-transfusion-and-treatment-paradigm-in-major-trauma-patients
#18
P Stein, A Kaserer, K Sprengel, G A Wanner, B Seifert, O M Theusinger, D R Spahn
Trauma promotes trauma-induced coagulopathy, which requires urgent treatment with fixed-ratio transfusions of red blood cells, fresh frozen plasma and platelet concentrates, or goal-directed administration of coagulation factors based on viscoelastic testing. This retrospective observational study compared two time periods before (2005-2007) and after (2012-2014) the implementation of changes in trauma management protocols which included: use of goal-directed coagulation management; admission of patients to designated trauma centres; whole-body computed tomography scanning on admission; damage control surgery; permissive hypotension; restrictive fluid resuscitation; and administration of tranexamic acid...
May 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28530772/characteristics-of-the-injuries-of-syrian-refugees-sustained-during-the-civil-war
#19
Betül Kocamer Şimşek, Mehmet Dokur, Erdal Uysal, Necdet Çalıker, Oruç Numan Gökçe, İbrahim Kürşat Deniz, Murat Uğur, Murat Geyik, Mehmet Kaya, Güner Dağlı
BACKGROUND: During a war, many civilians are severely injured by firearms, bombs, and shrapnel. The triage of war injuries involves difficult and complicated processes requiring surgical procedures and patient monitoring in the Intensive Care Unit (ICU) of hospitals. In this study, we examine the demographic, traumatic, and critical care characteristics of cases injured during the civil war in Syria and requiring emergency surgery. METHODS: Electronic data of the traumatic, surgical, and ICU monitoring features of 707 patients admitted to Kilis Public Hospital between March 2012 and January 2013 were analyzed retrospectively RESULTS: Most of the patients reported having been injured due to firearms (83...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28512392/utility-of-glissonean-pedicle-transection-for-surgical-treatment-of-severe-liver-trauma
#20
Satoshi Koizumi, Kenta Katsumata, Tatsunori Ono, Kouhei Segami, Hiroyuki Hoshino, Masafumi Katayama, Shinjiro Kobayashi, Junichi Matsumoto, Shigeki Fujitani, Yasuhiko Taira, Takehito Otsubo
The most common initial strategy for treatment of severe liver trauma is damage control in which hemostasis is achieved by perihepatic gauze packing and/or vascular embolization. However, we encounter patients in whom this strategy alone is not adequate. We have applied the principles of Glissonean pedicle transection, a technique that was originally devised to ensure safe and quick performance of planned hepatectomy for liver cancer, to 3 cases of severe liver trauma. We performed Glissonean pedicle ligation during damage control surgery in 2 patients and Glissonean pedicle transection during the definitive surgery in 1 patient...
January 2017: Case Reports in Gastroenterology
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